Healthcare Provider Details

I. General information

NPI: 1285516120
Provider Name (Legal Business Name): HARRY ESCOBAR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2025
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24619 WASHINGTON AVE STE 206
MURRIETA CA
92562-8228
US

IV. Provider business mailing address

24619 WASHINGTON AVE STE 206
MURRIETA CA
92562-8228
US

V. Phone/Fax

Practice location:
  • Phone: 951-698-0102
  • Fax:
Mailing address:
  • Phone: 951-698-0102
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number98610
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: